Out-of-pocket Costs

Out-of-pocket costs are the expenses that patients pay themselves for medical care, rather than their insurer or a public program. They include deductibles, copayments, coinsurance, and the amount left after an insurer pays. Insurers, employers, Medicare, Medicaid, and federal and state regulators all influence how much patients owe.

People usually ask how deductibles, copayments, and coinsurance differ and which costs count toward a yearly limit. They want to know how to estimate what a visit or procedure will cost and what tools exist to keep personal spending down.